EMOTIONAL INTELLIGENCE AMONG NURSING STUDENT IN UNIVERSITI MALAYSIA SARAWAK

Farrah Nadia Fouzi

Bachelor of Nursing with Honours (2008)

Faculty of Medicine and Health Sciences

Faculty of Medicine and Health Sciences

EMOTIONAL INTELLIGENCE AMONG NURSING STUDENT IN UNIVERSITI MALAYSIA SARAWAK

FARRAH NADIA BINTI FOUZI

11914

This research proposal is part of the Final Year Project in partial fulfilment of the requirements for

the degree of Bachelor of Nursing with Honours

Faculty of Medicine and Health Sciences UNIVERSITI MALAYSIA SARAWAK

(2008)

ii

ACKNOWLEDGEMENT

I wish to extend my profound appreciation to my supervisor, Mr. Merikan b. Aren for

his guidance, advice and encouragement towards the compilation of this project. My

heartful appreciation and thanks also go to the Mdm. Mazira bt. Mohd. Zain and Dr.

Mohd. Haizal b. Mohd. Noh for their cooperation and support in helping out with the

searching of references books in the campus library.

My special thanks also go to my course coordinator, Mdm. Rosalia Saimon for her

help and cooperation in data analysis, my mentor, Ms Sidiah John Siop, and all the

lecturers in the Faculty of Medicine and Health Sciences for their support and

guidance. To my housemates especially to Faezatul Akmal and Siti Salmah, my

coursemates and everybody who have been generous enough to share their knowledge

and made it possible for me to learn many things while finishing this research. I am

very grateful for your help of which I would not be finishing this project if there were

not be of your assistance.

Last but not least, to my parents, Fouzi b. Hj. Che Ha’at and Rohana bt. Kamarudin,

and my siblings for their undivided love, care, support and motivational guides that

always with me from the start without knowing how to give up. To those who are not

in the list, pardons me and you are not forgotten as all of you always have a place in

my heart. Thank you very much for the kind support and help.

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TABLE OF CONTENTS

Content Page

Abstract i

Acknowledgement ii

List of Tables vi

List of Figures vii

Abbreviations viii

Chapter I Introduction 1

Background of the problem

Problem statements

Objectives

Theoretical framework

Significance of the research

Definition of term

Chapter II Literature Review 11

Introduction

Emotion

Intelligence

Emotional intelligence

Level of emotional intelligence

Emotional intelligence in nursing

iv

Chapter III Methodology 17

Introduction

Research design

Research location

Research sample

Instrumentation

Pre-test study

Ethical consideration

Data collection

Data analysis

Chapter IV Results 25

Introduction

Demographic data distribution

Awareness of the importance of emotional intelligence

Emotional intelligence elements

Level of respondent’s awareness of emotional intelligence

Level of respondent’s emotional intelligence

Levels of the five elements of emotional intelligence

Relationships between two variables

v

Chapter V Discussion 36

Introduction

Findings and discussions of descriptive analysis

Background of respondent

Level of awareness of emotional intelligence

Level of emotional intelligence

Levels of the five elements of emotional intelligence

Chapter VI Conclusion 43

Implication

Limitation

Recommendation

Conclusion

References 47

Appendices

Appendix A: Ethical approval letter

Appendix B: Cover page of questionnaire

Appendix C: Research questionnaire

Appendix D: Participant informed consent form

vi

LIST OF TABLES

Tables Page

3.1 Topic by sections 20

3.2 Respondents degree of feedback 21

3.3 Section C Questionnaire Layout 21

4.1 Demographic data 26

4.2 Awareness of the importance of emotional intelligence 28

4.3 Overall emotional intelligence elements 29

4.4 Level of Awareness 30

4.5 Levels of overall respondent’s awareness 30

4.6 Level of awareness according to demographic data 31

4.7 Levels of emotional intelligence 32

4.8 Levels of overall respondent’s emotional intelligence 32

4.9 Level of emotional intelligence according to demographic data 33

4.10 Level of score according to elements of emotional intelligence 34

4.11 Level of elements of emotional intelligence 34

4.12 Relationship between variables 35

vii

LIST OF FIGURES

Figures Page

1.1 Theoretical framework of the research 5

3.1 Determining class intervals 24

viii

ABBREVIATIONS

EQ Emotional Quotient

EI Emotional intelligence

FMHS Faculty of Medicine and Health Sciences

IQ Intelligence Quotient

MoH Ministry of Health Malaysia

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ABSTRACT

Emotional Intelligence (EI) is the ability to recognize our own feelings and

those of others, for motivating ourselves, and for managing emotions well in

ourselves and others. It is a new knowledge and skills for the nurses that should be

cultivated in order to improve the nurses’ quality of work. The main aims of this study

are to identify the level of awareness and the level of EI among nursing students in

Universiti Malaysia Sarawak (UNIMAS). This study used a quantitative method and

109 nursing students were selected by convenience sampling. All data for the study

obtained from the questionnaire that was divided into three sections which were the

respondent’s background, awareness of the importance of emotional intelligence and

emotional intelligence elements. From the study, with regards of awareness, 54.1

percent (n=59) had low awareness of EI. Out of 109 respondents, only 21.1 percent

(n=23) of nursing students had a moderate level and the rest had a low level of EI.

Based on the results, Year 1 nursing students had the highest percentages of moderate

level. However, the overall level of EI among the nursing students was considered as

low. As a conclusion, the encouragement and guidance on the knowledge and

application of EI should be done. Consequently, the EI test was highly recommended

prior to enter nursing program in the future to promote high quality of emotionally

intelligent nurse outcome in the future.

1

CHAPTER I

INTRODUCTION

Conventionally, we have been made to believe that a person’s intellectual intelligence

(measured as IQ or intelligence quotient) is the greatest interpreter of success. Society

assumes that people with high IQs will obviously achieve more in life but with IQ

alone, a person is not categorised as intelligent because nowadays, researchers found

that person’s emotional intelligence (EI) might be a greater predictor of success than

his or her IQ. According to Weisinger (1998) cited in Moss (2005), emotional

intelligence is believed by many to be the determinant of who advances most quickly

within an organisation. Some companies even test their candidates as one of the

criteria for hiring employees.

A comprehensive theory of emotional intelligence was first proposed in 1990 by two

psychologist, Peter Salovey, and John Mayer (Moss, 2005). Then, a journalist and

psychologist, Dr. Daniel Goleman, took some of Mayer and Salovey's theory and

turned it into a best-selling book titled “Emotional Intelligence: Why It Can Matter

More than IQ”. Goleman in Emotional Intelligence notes: “... John Mayer, a

University of New Hampshire psychologist who, with Yale’s Peter Salovey, is a

coformulator of the theory of emotional intelligence." It describes abilities distinct

from, but complementary to, academic intelligence, the purely cognitive capacities

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measured by IQ. According to Daniel Goleman (1998), many people who are book

smart but lack emotional intelligence end up working for people who have lower IQs

than they but who excel in emotional intelligence skills.

Background of the problem

In Malaysia, emotional intelligence (EI) in practice is still not a big issue that may

arise in medical field especially for nurses. According to McQueen (2004), emotional

intelligence is a skill that deserves to be given credence in nursing for its potential

benefits to patients’ care and staff welfare. Nurses are the public face of the health

care system, the people who are actually perceived as taking care of the sick. They are

the frequent person who gets in touch with the patient and the most easiest available

person to attend patients who seek for medical attention.

Recently, Ministry of Health Malaysia (MOH, 2006), had stressed to all health care

providers in the government hospitals to practice 7 ‘S’ in the clinical settings to the

patient. The 7 ‘S’ consist of senyum (smile), salam (greet), sambut (welcome), segak

(smart), segera (urgent), sentuhan (touch) and sensitif (sensitive). These are the

behaviour that the nurses should act in the ward and it is the interpersonal and

intrapersonal skill that the nurses should learn and apply. These two skills are the

component of social intelligence to which EI has its roots in it. The 7 ‘S’ can develop

EI in the clinical settings and together to provide a quality work performances and

satisfaction of patients.

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Problem statements

Traditionally, nursing profession has been viewed as caretakers or caregiver. The

clients who seek for medical attention are those who are in need of special attention

and holistic care from the health care providers especially nurses. However, the

clients’ negative perceptions that had arise towards some of the nurses in Malaysia

and also the barrier that exist between nurse-patient relationships coerce the

researcher to develop this research study. Recently, in the newspaper article of Utusan

Malaysia dated 23 March 2007, the perception of the public about nurses in Malaysia

as being anger and impolite while treating clients had been stated numerously. The

nurses are not aware with their emotions in daily life. Therefore, it is imperative to

understand the clients feeling when the nurse serve their care. They put on their stress

to the patient in order to release their tension, stress and burnout. Aristotle, n.d. cited

in Anthikad, 2004, p.18 had proposed as:

“Anybody can become angry – that is easy; but to be angry with the right

person, and to the right degree, and at the right time, and for the right

purpose, and in the right way, that is not within everybody’s power and is not

easy.”

The emotion regulation reflects the ideas that are concerned with the concept of EI.

People who apply EI in their life, they will be able to control their feelings towards

anger. Instead, the nurses need to think and in a polite manner, interact with the client

in professional way. With the elements of emotional intelligence, all these problems

can be well-managed.

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On the other hand, technology also plays an important role in putting barrier between

the nurses and the patient relationship. Nowadays, technologies become more

sophisticated where nurses just deal with the machine and went off without really

looking at the clients’ complaints. They spend their time and interact less with the

client in the wards. According to Moss (2005), nurse only attend to the patient when

doing head to toe examinations, giving medications, verifying confirmation on

intravenous (IV) pumps and other equipments to run smoothly or whenever the client

call them. They spent most of their time by documenting (Moss, 2005). As a result,

they would not serve holistic care to the patient.

Objectives

General objective:

The general objectives of this study are to determine the level of awareness and the

level of emotional intelligence among nursing student.

Specific objectives:

1. To identify awareness of the importance of emotional intelligence among

nursing student.

2. To identify the level of emotional intelligence among nursing student.

3. To identify the level of self-awareness among nursing student.

4. To identify the level of self-regulation among nursing student.

5. To identify the level of motivation among nursing student.

6. To identify the level of empathy among nursing student.

7. To identify the level of social skills among nursing student.

5

Theoretical framework

In this study, the concept and description of EI have expanded into a framework for

describing human characters, as a set of emotional competencies that distinguish how

people manage feelings, interact and communicate in performing their work

effectively in achieving outstanding performance. As pointed out by Goleman (1998),

emotional competence is a learned capability based on EI that results in outstanding

performance at work. Therefore, our EI can be observed when we demonstrate our

emotional competencies that constitute self-awareness, self-management, social

awareness and social skills at appropriate times and ways in sufficient frequency to be

effective in the situation (Boyatzis, Goleman & Rhee, 1999). As a nurse, they need to

have these skills in achieving the patient’s health and providing the best services to

them.

Figure 1.1: Theoretical framework of the research

Emotional intelligence

level (5 elements)

Increased work performances of

nurses in the services

6

Significance of the research

This research would add more in-depth knowledge on emotional intelligence and also

determination of awareness and emotional intelligence level among nursing students.

It assists the future nurses to identify and aware their emotion towards the patient and

as well included other people around them such as family, colleagues and friends.

This study results may guide the nurses to change their way of work and interactions

with the patient especially to be more intelligent and dependable in managing their

emotions and towards building the nurse-patient relationship although they are busy

with their jobs and other responsibilities. Besides that, it will improve the holistic care

towards the patient and advancing the nursing practice in the clinical settings. This

research is to make its proper impact on patient care. The reason of this study, after

all, is to improve the quality of patient care and to increase the effectiveness and

efficiency of the nursing service.

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Definition of term

Nursing students

Nursing students is a future nurse who will complete a programme of basic nursing

education and is qualified and authorised in his or her own country to practise nursing

(Martin, 2003).

Concept of emotional intelligence

There are two elements that combines to create emotional intelligence; the element of

emotion and intelligence (Weisinger, 1998).

Emotion

According to Weisinger (1998), emotions can be divided into three components;

thoughts, physiological changes and behaviours. Emotion is a very strong feeling that

can influence our physiological and changes our behaviours and thoughts.

Intelligence

Intelligence is the ability to learn, understand and thinking a logical way about things;

the ability to do this well (Hornby, 2000). According to Wechsler (1958), intelligence

is the aggregate or global capacity of the individual to think rationally, to act

purposefully, and to deal effectively with the environment (Anthikad, 2004).

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Emotional intelligence

Conceptually, emotional intelligence is the capacity for recognizing our own feelings

and those of others, for motivating ourselves, and for managing emotions well in

ourselves and others (Goleman, 1995 cited in Elliott, 2007). Operationally, emotional

intelligence is the students’ capacity in knowing their feeling and the feeling of others,

motivating themselves and uses these emotions in handling relationships with friends,

colleagues and others. These are known as their self-awareness, self-regulation,

motivation, empathy and social skills.

Self-awareness

Conceptually, self-awareness define as knowing how we are feeling in the moment,

and using those preferences to guide our decision making; having realistic assessment

of our own abilities and a well-grounded sense of self confidence (Goleman, 1998).

Operationally, self-awareness is the ability of the person to recognise feelings when

they happen and acknowledge them. With this ability, we can make rational decisions

and allow and even act with extra caution after the decisions had been made.

Self-regulation

Conceptually, self-regulation define as handling our emotions so that, they facilitate

rather than interfere with the task at hand; being conscientious and delaying

gratification to pursue goals; recovering well from emotional stress (Goleman, 1998).

Operationally, it is the ability to handle uncomfortable emotions and able to overcome

it in difficult situations. A nurse with this ability will be able to handle the patients

and the other colleague in a stress or burnout situation in the ward.

9

Motivation

Conceptually, motivation defines as using our deepest preferences to move and guide

us toward our goals, to help us take initiative and strive to improve and to persevere in

the face of setbacks and frustrations (Goleman, 1998). Operationally, motivation

reflects the nurses’ passion for work beyond money or status and has the tendency to

pursue goals with persistence. This would be the ability of the workers to use

emotional system to start a work process and keep it going (Weisinger, 1998).

Empathy

Conceptually, empathy defines as the capacity to understand and respond to the

unique experiences of another (Micoli & Ketcham, 2000). Operationally, it is sensing

what people feeling, being able to take their perspective, and cultivating rapport and

attunement with a broad diversity of people. Emotional work can involve nurses in

managing instinctive emotions such as disgust, annoyance or frustration in patient

interactions (Goleman, 1998). By trying to view the situation from patients’

perspectives and empathizing with their emotions, nurses’ facial expressions and

behaviour can be managed to display caring behaviour (McQueen, 2004).

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Social skills

Conceptually, social skills define as handling emotions in relationships well and

accurately reading social situations and networks; interacting smoothly; using these

skills to persuade and lead, negotiate and settle disputes, for cooperation and

teamwork (Goleman, 1998). Operationally, building of relationships and networking

does not merely depending on power and predefined roles. This skill will give person

ability in developing and managing relationships with the patients and colleague and

has the ability to find common position and build rapport in the hospital.

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CHAPTER II

LITERATURE REVIEW

Introduction

This chapter is reviewing the past literature on emotions, emotional intelligence and

also the emotional intelligence element. In this chapter, the researcher would try to

understand the meaning of emotions, intelligence and emotional intelligence in the

context of nursing in the clinical field.

Emotion

Emotions are powerful forces influencing our behavior; people laugh, cry, become

depressed, or blow up buildings under the influence of emotions (Plutchik, 2003).

Emotion colours everything that we do. Without emotion, life would be dull. Emotion

is always present in one form or another as a basic aid to our survival. It is our

emotional reactions to the world that allow to us determine which parts of it are safe

for us and which are dangerous, which will bring happiness and of which bring

sadness or anger or depression. At the most fundamental level, emotion provides us

with information about ourselves that is essential in our struggle to deal with daily life

(Strongman, 2006).

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Nurses, as patients’ lifelines, needs to understand the emotional dimensions in the

clinical situations. People that come to the hospital have various behaviours.

Recognizing emotions and facilitating the transition from one to another are skills of

emotional intelligence that serve nurses in such settings (Moss, 2005). In other point

of view, emotional identification, the most basic level of emotional aptitude in Mayer,

Salovey, and Caruso’s model, involves recognizing emotion in art work or a facial

expression (Mayer, Salovey, and Caruso, 1999, 2000, 2002 cited in Moss, 2005).

On the other hand, Davies, Stankov, and Roberts (1998) cited in Plutchik (2003)

found that many of the emotional intelligence scales correlated highly with

personality scale measures, thus suggesting that emotional intelligence may in fact be

an aspect of personality. Indeed, it is evident that most of the terms used to describe

emotions are also used to describe personality traits (Plutchik, 2003).

Intelligence

Intelligence consists of three types that can be concluded from Howard Gardner’s

Theory of Intelligence, which are the Mechanical intelligence, Social intelligence and

Abstract (general) intelligence. Emotional intelligence can be categorised in the

Social intelligence; it means understanding of people and the ability to act wisely in

human relationships (Anthikad, 2004). Moreover, according to Howard Gardner’s

Theory of Intelligence, social intelligences include of intrapersonal and interpersonal

intelligence.

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Intrapersonal intelligence is also demanded in nursing when nurses empathize with

patients, try to understand their perspectives and engage in counselling skills. In these

circumstances, it is recommended that nurses have engaged in a self-reflective process

to become aware of their own values and prejudices. Any personal prejudices that

conflict with those of patients or clients can then be set aside in helping patients come

to their own decision, appropriate to their circumstances (Burnard 1994 cited in

McQueen, 2004). The social adeptness referred to above is demonstrated in the

definition of EI proposed by Freshman and Rubino (2002, p. 1) as:

“Proficiency in intrapersonal and interpersonal skills in the areas of self-

awareness, self-regulation, self-motivation, social awareness and social

skills.”

Emotional intelligence

Emotional intelligence has its roots in the social intelligences first proposed by

Thorndike (1920) cited in McQueen (2004), who noted that it was of value in human

interactions and relationships. He concluded that social intelligence was discrete from

academic abilities and was a key to success in the practicalities of life. Then, a

comprehensive theory of emotional intelligence had been first proposed in 1990 by

two psychologist, John Mayer, and Peter Salovey. According to Mayer & Salovey

(1997) cited in Eysenck (2004), emotional intelligence is the ability to perceive

emotions, to access and generate emotions so as to assist thought, to understand

emotions and emotional knowledge, and to reflectively regulate emotions so as to

promote emotional and intellectual growth.

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Goleman (1998) adapted the model by Salovey and Mayer (1990) to give an

understanding of how these talents matter in work life and it includes the five basic

emotional and social competencies:

• Self-awareness: Knowing what we are feeling in the moment, and using those

preferences to guide our decision making; having a realistic assessment of our

own abilities and well-grounded sense of self-confidence.

• Self-regulation: handling our emotions so that, they facilitate rather than

interfere with the task at hand; being conscientious and delaying gratification

to pursue goals; recovering well from emotional distress.

• Motivation: using our deepest preferences to move and guide us toward our

goals, to help us take initiative and strive to improve, and to persevere in the

face of setbacks and frustrations.

• Empathy: Sensing what people are feeling, being able to take their

perspective, and cultivating rapport and attunement with a broad diversity of

people.

• Social skills: Handling emotions in relationships well and accurately reading

social situations and networks; interacting smoothly; using these skills to

persuade and lead, negotiate and settle disputes, for cooperation and

teamwork.

Level of emotional intelligence

Level of emotional intelligence is not fixed genetically, nor does it develop only in

childhood. EI seems to be largely learned and it continues develop as we go through

life and learn from our experiences, our competence in it can keep growing.